Randomized controlled pilot of a group antenatal care model and the sociodemographic factors associated with pregnancy-related empowerment in sub-Saharan Africa.
Randomized controlled pilot of a group antenatal care model and the sociodemographic factors associated with pregnancy-related empowerment in sub-Saharan Africa.
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DOI：
10.1186/s12884-017-1493-3
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发表时间：
2017-11-08
影响因子：
3.1
通讯作者：
Norr KF
中科院分区：
文献类型：
--
作者：
Patil CL;Klima CS;Leshabari SC;Steffen AD;Pauls H;McGown M;Norr KF
在撒哈拉以南非洲，赋权与一些与健康有关的结果之间的联系已得到记录，但与怀孕有关的赋权尚未得到充分调查。产前护理（ANC）是大多数妇女进入医疗保健系统的切入点，因此了解ANC如何影响妇女对怀孕的控制感是很重要的。我们比较了两个撒哈拉以南国家马拉维和坦桑尼亚随机分配到标准护理组和以妊娠为基础的ANC（干预）组的妇女的妊娠相关赋权情况。马拉维（n = 112）和坦桑尼亚（n = 110）的孕妇被招募到一项试点研究中，随机分为个体或群体。马拉维和坦桑尼亚的妊娠后期滞留率分别为81%和95%。在这两个国家，被称为重点产前护理（FANC）的个人产前护理是标准护理。母婴健康中心建议进行四次产前检查，加上产后6周的检查，并按照国家护理标准实施。在ANC组中，每次接触包括在小组空间进行自我评估和助产士评估，以及90分钟的互动式健康促进。两种研究条件下的接触次数是相同的。我们使用妊娠相关赋权量表（PRES）测量妊娠后期的妊娠相关赋权。采用独立样本t检验和多元线性回归来评估ANC组是否比ANC个体导致更高的PRES评分，并调查与妊娠相关赋权相关的其他社会人口因素。在马拉维，ANC组的妇女比单独ANC组的妇女的PRES得分更高。护理类型是PRES的重要预测因子，可以解释67%的差异。在坦桑尼亚，情况并非如此；两种护理的PRES评分相似。包括社会人口学变量在内的预测模型显示，宗教是坦桑尼亚治疗效果的潜在调节因素。ANC组中穆斯林妇女的平均PRES得分高于单独ANC组；这一差异在基督教女性中没有观察到。非洲人国民大会在某些情况下赋予孕妇权力。需要更多的研究来确定ANC模式在全球范围内影响与妊娠相关的赋权以及围产期结局的方式。本文的在线版本（doi:10.1186/s12884-017-1493-3）包含补充材料，可供授权用户使用。
The links between empowerment and a number of health-related outcomes in sub-Saharan Africa have been documented, but empowerment related to pregnancy is under-investigated. Antenatal care (ANC) is the entry point into the healthcare system for most women, so it is important to understand how ANC affects aspects of women’s sense of control over their pregnancy. We compare pregnancy-related empowerment for women randomly assigned to the standard of care versus CenteringPregnancy-based group ANC (intervention) in two sub-Saharan countries, Malawi and Tanzania. Pregnant women in Malawi (n = 112) and Tanzania (n = 110) were recruited into a pilot study and randomized to individual ANC or group ANC. Retention at late pregnancy was 81% in Malawi and 95% in Tanzania. In both countries, individual ANC, termed focused antenatal care (FANC), is the standard of care. FANC recommends four ANC visits plus a 6-week post-birth visit and is implemented following the country's standard of care. In group ANC, each contact included self- and midwife-assessments in group space and 90 minutes of interactive health promotion. The number of contacts was the same for both study conditions. We measured pregnancy-related empowerment in late pregnancy using the Pregnancy-Related Empowerment Scale (PRES). Independent samples t-tests and multiple linear regressions were employed to assess whether group ANC led to higher PRES scores than individual ANC and to investigate other sociodemographic factors related to pregnancy-related empowerment. In Malawi, women in group ANC had higher PRES scores than those in individual ANC. Type of care was a significant predictor of PRES and explained 67% of the variation. This was not so in Tanzania; PRES scores were similar for both types of care. Predictive models including sociodemographic variables showed religion as a potential moderator of treatment effect in Tanzania. Muslim women in group ANC had a higher mean PRES score than those in individual ANC; a difference not observed among Christian women. Group ANC empowers pregnant women in some contexts. More research is needed to identify the ways that models of ANC can affect pregnancy-related empowerment in addition to perinatal outcomes globally. The online version of this article (doi:10.1186/s12884-017-1493-3) contains supplementary material, which is available to authorized users.
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赋予性别能力在尼日利亚城市生殖健康成果上的作用。
影响因子：
2.3
作者：
Corroon M;Speizer IS;Fotso JC;Akiode A;Saad A;Calhoun L;Irani L
通讯作者：
Irani L
影响因子：
3.3
作者：
Conrad, Paul;Schmid, Gerhrd;Sarker, Malabika
通讯作者：
Sarker, Malabika
影响因子：
3.3
作者：
Ickovics JR;Reed E;Magriples U;Westdahl C;Schindler Rising S;Kershaw TS
通讯作者：
Kershaw TS
影响因子：
2.7
作者：
Grady, MA;Bloom, KC
通讯作者：
Bloom, KC
影响因子：
3.5
作者：
Holmstrom, Inger;Roing, Marta
通讯作者：
Roing, Marta